Provider Demographics
NPI:1205837135
Name:HOEVET, ROSS HOWARD (DMD)
Entity Type:Individual
Prefix:DR
First Name:ROSS
Middle Name:HOWARD
Last Name:HOEVET
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13520 SE 97TH AVE
Mailing Address - Street 2:
Mailing Address - City:CLACKAMAS
Mailing Address - State:OR
Mailing Address - Zip Code:97015-7691
Mailing Address - Country:US
Mailing Address - Phone:503-652-2689
Mailing Address - Fax:503-652-2638
Practice Address - Street 1:13520 SE 97TH AVE
Practice Address - Street 2:
Practice Address - City:CLACKAMAS
Practice Address - State:OR
Practice Address - Zip Code:97015-7691
Practice Address - Country:US
Practice Address - Phone:503-652-2689
Practice Address - Fax:503-652-2638
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-02
Last Update Date:2008-05-05
Deactivation Date:2006-03-22
Deactivation Code:
Reactivation Date:2006-03-29
Provider Licenses
StateLicense IDTaxonomies
ORD6274122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist